Getting my equivalencia (aka: my midwifery degree recognized in Mozambique) has been a journey --a long and difficult journey. One that I hope never to have to do again!
I started the process in October of 2013. For several years, the powers that be kept misplacing, ignoring, and ultimately passing my application around until it was looked at and pondered by just about everyone in the great city of Maputo.
It didn’t help that in the process of shuffling my application about and wasting so much time, that it got lost. Again and again. I had to re-submit my application four times.
Yes, four.
Nor did it seem to phase my would-be torturers that it was taking so long.
The fact of the matter was that they just didn’t know what to do with me or my degree. They didn’t want to deny me straight out (which of course is a good thing) but they couldn’t figure out what to approve me as. Was I a doctor? No. Was I a nurse? Not exactly. My degrees said I was more qualified than their nurses. I had specialty knowledge that gave me special privileges. If the closest thing was to call me a nurse... then what level of nurse would they make me? These questions and many more where their daily confusion...
... and my daily trial.
Meanwhile the coming and going, the constant (and ridiculously difficult) following up I had to do, was taking its toll. I couldn’t imagine taking another (horrendous) bus to Maputo only to find out that they were still doing nothing but losing my files. I was ready to give up.
It had been over two years by this point.
After yet another fruitless and exhausting trop to Maputo, I told a Mozambican friend that I was giving up. He lives in Maputo and understood the system. He told me it was too early to give up and encouraged me to hold on. I reminded him of all the crazy hoops I’d had to jump through and complained that I was unable to jump through another. He reminded me that giving up was not the same thing as a closed door.
I agreed with a sigh.
But then he did something even better. He offered to beat on the government doors, then he proceeded to do just that. As I bused my way back to Maforga, he went weekly and sometimes daily to chase after a response. He made himself known and liked. He pushed and pushed, smiled when he wanted to wring necks, and basically played the system.
Every now and again, he’d call me to say that it could be done MUCH faster if I’d just concede to paying a bribe. Tempting though it was at times, I’d remind him that I would not pay a bribe of any kind. If God didn’t want me here in the country, then He’d shut the door.
Another year went by.
But this year was different; things moved. After our first sign of progress, I was disheartened to learn that the powers-that-be decided to tentatively approve my degree. But before they’d put the final stamp of approval, I had to take a practical exam.
My stomach dropped at the very idea.
The exam had to be scheduled through a medical university in Maputo. I’d have eight or nine practical skills to complete and each skill would be evaluated and graded by a different teacher.
Bile rose in my throat.
Plus, the exam was going to be in Portuguese.
Ugg.
To say that I was nervous would be an understatement. To say that I was terrified of failing and having all this effort wasted... would be closer to the truth.
I was a ball of tightly wound nerves and could find no peace.
Plus, the topics they suggested I study were very difficult to wrap my brain around. They were things I knew well but the things that they emphasized as important were odd (i.e. I could fail if I didn’t palpate in a clockwise rotation or greet the patient/mannequin by their last name and title). Basically, they could fail me over the smallest infraction.
Finding time to study was a challenge as well. Mind you, the clinic had just opened and I was needed on every side to juggle the chaos.
Time rolled on and eventually, my exam date neared. I had to go whether I was ready or not. And let me just say this right now... I did not feel ready. Not one bit!
I showed up for my exam on the day scheduled only to learn that the main teacher had forgotten to arrange my exam. They asked me to come back the following day.
My nerves continued to fray.
The Lord kept trying to encourage me but no matter how hard I tried, I felt no peace. I’d vacillate from faith to fear, to joy then despair. It was probably very difficult to watch. It was much more difficult to experience, let me tell you!
I’m not proud of this... but most of my fears were bound up in pride. What if I failed? I’d have to leave and would never be able to teach nurse-midwives from the villages, nor deliver babies on my own. I worried and worried. What if all I had done up to this point had been wasted and for naught?
I was physically sick at the thought.
To understand what comes next I need to explain two things. First, I am NOT a nervous test taker. I cannot remember the last time I worried over a test, other than this one. Second, among the Mozambican educational system, there appears to be a significant hierarchal structure. Students are expected to never question what they are taught and show intense deferential respect to their teachers.
On the day of my exam, I didn’t recognize myself. My fears of failure brought on a severe case of the nerves, which brought on massive doubt, which left me looking like an insecure, incompetent fool.
I was physically trembling.
My examiners tried to put me at ease and I tried to be at ease. But then the stop clocks came out.
What? I would be timed on this? What on earth for? Who completes a baby exam in less than ten minutes while still somehow teaching the mother on best care methods?
Every exam module I passed proved to increase my sense of impending doom. After each test, all I could think of was what I had forgotten to do or rushed to do too quickly in a desperate attempt to finish ‘on time’.
By the time I finished my fourth procedure, one of the nurses suggested I take a break. I was sweating bullets, trembling, and forgetting silly things. But I refused to take a break, focusing on finishing at all costs.
After the following exam module (a neonatal resuscitation) was a massacre of hurried motions and baffling non-starts, they finally insisted I go outside for a breath of fresh air.
I was a mess.
I was drenched in sweat, and breathing hard. I cannot remember the last time I was such a chaotic mess. What was happening to me?
I prayed and asked God for help. But nothing changed. No peace came. All I could think about was how I was fouling this up big time.
Five minutes passed and I returned to the exam room.
It got worse.
Seriously, where was my brain?
I kept forgetting things that made no sense. Why didn’t I lift that mannequin's legs? She was obviously in shock! What on earth was I doing trying to fill the indwelling catheter with the needle and not the syringe? Seriously, I was losing it.
By the time two more skills had been completed, I was convinced without a shadow of a doubt that I had failed. I finished the last few skills exams in utter despair.
I’d failed. I’d let myself down. But more importantly, I’d let God down.
The examiners asked me to wait outside while they compared my scores. It was a sad ten minutes. I wallowed in despair and doubt.
Had I been in their shoes, there is NO way I would have passed me. None.
When they called me in, they first asked me how I felt I did. I was honest. I told them, I was very nervous and that I think I failed. I didn’t make any excuses but confessed I could not understand why I was so nervous.
Then they went around the room and told me how they thought I did. Some of the teachers were less than impressed but could see that I had skills. Over and over they remarked on how nervous I was and wondered at it.
Finally, the main examiner said, “We know that you did not learn your skills on mannequins like we do here. But we can see that you know what you are doing. Congratulations, you passed!”
The shock I felt at those words cannot be expressed in words.
“What? Really? I’m a Mozambican midwife now?”, I stuttered.
“Yes. You are. Congratulations!” She added, bright with excitement for me.
Smiling ear to ear, I repeated in shock, “I’m one of you? I’m a Mozambican midwife? Really?”
They all smiled and nodded. Happy laughter filled the room.
We continued to laugh, I took photos, and a few of my examiners filtered out of the room. I stayed in stunned joy. God had done a miracle. They had had grace towards me. They could have rejected me, but didn’t. Praise Him!
Before I left, the head examiner asked for all my contact details. She wanted to stay in touch in case I ever wanted a job.
A job?
I laughed at the thought. How could such a poor showing end in a job offer? But she was serious. She said she liked that I spoke Portuguese so well (a huge shocker!) and that she could see I had lots to offer other students in the program.
I thanked her and told her I had my hands full at the moment with the clinic. But the offer was kind. Very kind.
I left that day in awe of God’s graciousness. I left in absolute wonder. And as I shared with my friends later on they rejoiced with me.
More than once, however, the enemy tried to convince me that I passed because I’m just so smart and capable. Pride tried to sneak in again and again. When these thoughts surfaced, I would stop them and seriously remember just how miserably I did.
No! There is NO way that my skills, my talent, or my studying made one iota of difference in this miracle.
No. God did this. He alone gets all the glory!
When I shared what happened with some seasoned expats, one pointed out something I had not considered. She remarked that my nervousness no doubt put them in a position of power.
Confused by her statement, I asked her to explain.
She pointed out that my nervousness was a good thing because it put them in the position to be gracious and gain honor. Granting me mercy (by passing me despite my many mistakes) made them look good and brought them honor. She also suggested that had I come in there with confidence and proud expectation, they could have very well reacted quite differently.
I think she might be on to something.
Now when I look back, I see the Lord’s hand so much clearer. It explains why His peace never came. He needed me nervous.
In such a shame based culture, I think He decided to make the nervous things of the world, to confound the confident.
Whatever the reason or plan, I praise Him.
Once again, I’m reminded how He uses foolish, flawed, and faithless vessels to do the miraculous.
Happy Addendum:
A few months later when my official equivalencia diploma was mailed out, I got another surprise.
Instead of making me a nurse, they made me a physician’s assistant. By so doing, they have given me more flexibility in running the clinic and more freedom to teach in the future.
I didn’t ask for it, nor did I even know that such a thing could happen.
When God does a thing, He does it well!
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